A persuasão do terapeuta como capacidade preditora de resultados clínicos em psicoterapia

Dissertação de Mestrado apresentada no ISPA – Instituto Universitário para obtenção de grau de Mestre na especialidade de Psicologia Clínica.Objectivo: A literatura tem vindo a revelar que grande parte dos resultados clínicos podem ser explicados por um conjunto de fatores transversais a qualquer abordagem terapêutica. A pessoa do terapeuta surge neste contexto como um dos fatores que mais influencia o processo e os resultados terapêuticos (Baldwin & Imel 2013). No entanto, ainda pouco se sabe quanto aos factores que moderam estes efeitos do terapeuta e o que poderá ser feito para os potenciar (Cuijpers, 2018a). A literatura disponível sugere que uma atitude persuasiva do terapeuta em contexto clínico poderá influenciar significativamente os resultados terapêuticos (Anderson et al., 2013). Assim sendo, este estudo pretende investigar, detalhadamente, o impacto da persuasão no processo terapêutico, focando o comportamento persuasivo do terapeuta e o impacto desse comportamento no cliente, ao longo acompanhamento. Método: Foram selecionadas de forma aleatória vinte e sete gravações em vídeo de sessões psicoterapêuticas de nove díades, cada uma constituída por um cliente e um psicoterapeuta, tendo sido analisadas três sessões de psicoterapia por díade. Os principais instrumentos para recolha de dados foram o Psychotherapy Persuasiveness Scale (PPS), Symptom Checklist-90-R (SCL-90-R) e Penn State Worry Questionnaire PSWQ. Os dados foram analisados através de procedimentos estatísticos com recurso ao programa Statistical Package for the Social Sciences (SPSS). Resultados: Os resultados obtidos revelam que a persuasão se encontra associada aos resultados terapêuticos obtidos, sendo capaz de prever estes mesmo resultados de forma significativa, em sensivelmente 17%. Emergiram ainda outros resultados pertinentes no contexto desta investigação, como é o caso dos resultados que revelam uma forte associação entre o nível de persuasão dos psicoterapeutas ao longo das sessões terapêuticas e o resultado clínico após a intervenção. Conclusões: A persuasão parece constituir-se como uma capacidade interpessoal facilitadora do psicoterapeuta relevante no contexto clínico, ao longo do processo terapêutico, contribuindo para uma melhoria dos resultados terapêuticosObjective: The literature has revealed that much of the clinical results can be explained by a set of factors transversal to any therapeutic approach. The therapist's person emerges in this context as one of the factors that most influences the therapeutic process and outcomes (Baldwin & Imel 2013). However, little is known about the factors that moderate these therapist effects and what can be done to enhance them (Cuijpers, 2018a). The available literature suggests that a persuasive attitude of the therapist in a clinical context may significantly influence therapeutic outcomes (Anderson et al., 2013). Therefore, this study intends to investigate in detail the impact of persuasion on the therapeutic process, focusing on the therapist's persuasive behavior and the impact of this behavior on the client over the course of follow-up. Method: Twenty-seven video recordings of nine dyad psychotherapeutic sessions were randomly selected, each consisting of one client and one psychotherapist, and three dyad psychotherapy sessions were analyzed. The main instruments for data collection were the Psychotherapy Persuasiveness Scale (PPS), Symptom Checklist-90-R (SCL-90-R) and Penn State Worry Questionnaire PSWQ. Data were analyzed using statistical procedures using the Statistical Package for Social Sciences (SPSS) program. Results: The results show that persuasion is associated with the therapeutic results obtained, being able to predict these same results significantly, by approximately 17%. Other pertinent results emerged in the context of this investigation, such as the results that reveal a strong association between the level of persuasion of psychotherapists throughout the therapeutic sessions and the clinical outcome after the intervention. Conclusions: Persuasion seems to be a facilitating interpersonal capacity of the relevant psychotherapist in the clinical context, throughout the therapeutic process, contributing to an improvement of the therapeutic results

Fluid–Structure Interaction Modeling of Ascending Thoracic Aortic Aneurysms in SimVascular

Publisher Copyright: © 2022 by the authors.Ascending Thoracic Aortic Aneurysm (ATAA) is a permanent dilatation of the aorta which is usually related to tissue degeneration, hemodynamic conditions, lifestyle, environmental and genetic factors. As the mechanical conditions can become critical in a dilated aorta, a patient-specific computational model can be very useful to assist clinical decisions in the management of ATAAs. In this article, we model the biomechanical conditions of ATAA by performing Fluid–Structure Interaction (FSI) simulations in the SimVascular open-source software package. The patient-specific geometric model is reconstructed from Computed Tomography scan (CT). The numerical implementation takes into account patient-specific outlet conditions and a temporal flow variation at the model inlet. We performed a mesh convergence analysis on a new mesh reconstruction method in SimVascular and showed that it can significantly reduce the computational cost without impacting the accuracy.publishersversionpublishe

A biology-driven deep generative model for cell-type annotation in cytometry

Cytometry enables precise single-cell phenotyping within heterogeneous populations. These cell types are traditionally annotated via manual gating, but this method suffers from a lack of reproducibility and sensitivity to batch-effect. Also, the most recent cytometers - spectral flow or mass cytometers - create rich and high-dimensional data whose analysis via manual gating becomes challenging and time-consuming. To tackle these limitations, we introduce Scyan (https://github.com/MICS-Lab/scyan), a Single-cell Cytometry Annotation Network that automatically annotates cell types using only prior expert knowledge about the cytometry panel. We demonstrate that Scyan significantly outperforms the related state-of-the-art models on multiple public datasets while being faster and interpretable. In addition, Scyan overcomes several complementary tasks such as batch-effect removal, debarcoding, and population discovery. Overall, this model accelerates and eases cell population characterisation, quantification, and discovery in cytometry

A Systematic Review and Discussion of the Clinical Potential

Funding Information: Funding by Portuguese Foundation for Science and Technology (FCT-MCTES) under the following projects: PTDC/EMD-EMD/1230/2021—Fluid-structure interaction for functional assessment of ascending aortic aneurysms: a biomechanical-based approach toward clinical practice ; UNIDEMI UIDB/00667/2020; A. Mourato PhD grant UI/BD/151212/2021; R. Valente PhD grant 2022.12223.BD. Publisher Copyright: © 2022 by the authors.Aortic aneurysm is a cardiovascular disease related to the alteration of the aortic tissue. It is an important cause of death in developed countries, especially for older patients. The diagnosis and treatment of such pathology is performed according to guidelines, which suggest surgical or interventional (stenting) procedures for aneurysms with a maximum diameter above a critical threshold. Although conservative, this clinical approach is also not able to predict the risk of acute complications for every patient. In the last decade, there has been growing interest towards the development of advanced in silico aortic models, which may assist in clinical diagnosis, surgical procedure planning or the design and validation of medical devices. This paper details a comprehensive review of computational modelling and simulations of blood vessel interaction in aortic aneurysms and dissection, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). In particular, the following questions are addressed: “What mathematical models were applied to simulate the biomechanical behaviour of healthy and diseased aortas?” and “Why are these models not clinically implemented?”. Contemporary evidence proves that computational models are able to provide clinicians with additional, otherwise unavailable in vivo data and potentially identify patients who may benefit from earlier treatment. Notwithstanding the above, these tools are still not widely implemented, primarily due to low accuracy, an extensive reporting time and lack of numerical validation.publishersversionpublishe

Response to oxidative stress induced by cadmium and copper in tobacco plants (Nicotiana tabacum) engineered with the trehalose-6-phosphate synthase gene (AtTPS1)

The response of tobacco plants genetically engineered with the AtTPS1 gene to stress induced by excess Cu and Cd was evaluated in hydroponic solution (100 and 400 lM Cu and 50 and 200 lM Cd) after a 48 h exposure. Two transgenic lines, transformed with the AtTPS1 (trehalose-6-phosphate synthase) gene from Arabidopsis, with different levels of trehalose-6-phosphate synthase expression (B5H, higher and B1F, lower), and a wild type (WT) were investigated. Protein content, antioxidative enzymes (CAT, POD, SOD, and APX), glucose, fructose, lipid peroxidation, hydrogen peroxide and Cd and Cu contents were determined in leaves. The two transgenic lines were differently influenced by Cd and Cu exposure as they induced a different antioxidant enzymatic defense response. B1F and B5H plants showed a better acclimation to Cd and excess Cu compared to WT. Furthermore B1F was more tolerant than B5H to Cd and excess Cu. B1F accumulated less Cd and Cu in leaves, probably due to a more efficient exclusion mechanism. Catalase was shown to be the most important enzyme in the antioxidative system of these plants

Evaluation of tissue and circulating mir-21 as potential biomarker of response to chemoradiotherapy in rectal cancer

This research received funding from European Structural & Investment Funds through the COMPETE Programme—Programa Operacional Regional de Lisboa—Programme Grant LISBOA-01-0145-FEDER-016405,and from National Funds through FCT—Fundação para a Ciência e a Tecnologia—Programme Grant SAICTPAC/0019/2015.Response to chemoradiotherapy (CRT) in patients with locally advanced rectal cancer (RC) is quite variable and it is urgent to find predictive biomarkers of response. We investigated miR-21 as tissue and plasma biomarker of response to CRT in a prospective cohort of RC patients; The expression of miR-21 was analyzed in pre-and post-CRT rectal tissue and plasma in 37 patients with RC. Two groups were defined: Pathological responders (TRG 0, 1 and 2) and non-responders (TRG 3). The association between miR-21, clinical and oncological outcomes was assessed; miR-21 was upregulated in tumor tissue and we found increased odds of overexpression in pre-CRT tumor tissue (OR: 1.63; 95% CI: 0.40–6.63, p = 0.498) and pre-CRT plasma (OR: 1.79; 95% CI: 0.45–7.19, p = 0.414) of non-responders. The overall recurrence risk increased with miR-21 overexpression in pre-CRT tumor tissue (HR: 2.175, p = 0.37); Significantly higher miR-21 expression is observed in tumor tissue comparing with non-neoplastic. Increased odds of non-response is reported in patients expressing higher miR-21, although without statistical significance. This is one of the first studies on circulating miR-21 as a potential biomarker of response to CRT in RC patients.publishersversionpublishe

Trophic-mediated pelagic habitat structuring and partitioning by sympatric elasmobranchs

Funding provided by the TRIATLAS project through the European Union’s Horizon 2020 Research and Innovation Programme (grant No. 817578), the Conselho Nacional de Desenvolvimento Cientı́fico e Tecnológico - CNPq (478070/2008-0, 482557/2011-7), the Fundação Grupo Boticário (0760/2007.2), the Save Our Seas Foundation (66/2008), and the Fundação para a Ciência e Tecnologia – FCT (UIDB/04292/2020; UIDP/04292/2020), is deeply acknowledged. Scholarships granted by the FACEPE foundation to NPAB and by CNPq to BCLM (140567/2012-7) are also acknowledged. We acknowledge the Instituto Chico Mendes de Conservação da Biodiversidade (ICMBio), the Brazilian Navy (SECIRM) and the Conselho Nacional de Desenvolvimento Cientı́fico e Tecnológico (CNPq) through the Pró-Arquipélago Program (557183/2009-0; 562062/20102-6; 405460/2012-0; 442884/2015-0) for providing precious logistic support.Pelagic elasmobranchs are key elements of oceanic ecosystems and must be preserved if marine trophic networks are to be kept in balance. Yet, they face intense fishing pressure that has been threatening their populations worldwide. Ensuring proper conservation management of these taxa depends on a better understanding of the strategies they use to explore the pelagic realm and their contributions to trophic web structuring across the ocean column. This study aimed at examining relationships between vertical habitat use and trophic attributes among six sympatric pelagic elasmobranchs using satellite transmitting tags in the western equatorial South Atlantic Ocean. The vertical movements of 35 elasmobranch individuals were tracked during an overall total of 1911 days. Clear relationships between species’ feeding habits, maximum diving depths, and proportion of time spent either in epipelagic or in surface waters were evidenced by Bayesian generalized linear mixed models and multivariate analysis. Filter-feeders made most use of deep waters from the mesopelagic and bathypelagic and shifted their diving depths in phase with diel vertical migrations of the deep scattering layer, i.e., shallower during the night and deeper during the day. Specialists exhibited distinct diving patterns in epipelagic and mesopelagic waters across the diel period which are potentially indicative of habitat partitioning, whereas generalists were more surface-oriented but also explored deeper waters compared to specialists. The trophic level also seemed to influence elasmobranch maximum diving depths, which tended to become shallower as species’ trophic level increased. These results corroborate previous evidence of widespread vertical habitat partitioning among sympatric pelagic predators and depict a trophicmediated structuring of the pelagic environment where top-down control may be exerted at different depths by distinct species. Further research is yet required to understand the role of elasmobranch vertical movements in structuring pelagic habitats as well as to guide ecosystem-based fisheries management aimed at reducing species susceptibility to fishing gear and at preserving the structure and functionality of marine trophic networks.info:eu-repo/semantics/publishedVersio

Evaluation of Tissue and Circulating miR-21 as Potential Biomarker of Response to Chemoradiotherapy in Rectal Cancer

Response to chemoradiotherapy (CRT) in patients with locally advanced rectal cancer (RC) is quite variable and it is urgent to find predictive biomarkers of response. We investigated miR-21 as tissue and plasma biomarker of response to CRT in a prospective cohort of RC patients; The expression of miR-21 was analyzed in pre- and post-CRT rectal tissue and plasma in 37 patients with RC. Two groups were defined: Pathological responders (TRG 0, 1 and 2) and non-responders (TRG 3). The association between miR-21, clinical and oncological outcomes was assessed; miR-21 was upregulated in tumor tissue and we found increased odds of overexpression in pre-CRT tumor tissue (OR: 1.63; 95% CI: 0.40–6.63, p = 0.498) and pre-CRT plasma (OR: 1.79; 95% CI: 0.45–7.19, p = 0.414) of non-responders. The overall recurrence risk increased with miR-21 overexpression in pre-CRT tumor tissue (HR: 2.175, p = 0.37); Significantly higher miR-21 expression is observed in tumor tissue comparing with non-neoplastic. Increased odds of non-response is reported in patients expressing higher miR-21, although without statistical significance. This is one of the first studies on circulating miR-21 as a potential biomarker of response to CRT in RC patients.info:eu-repo/semantics/publishedVersio

Potential of miR-21 to Predict Incomplete Response to Chemoradiotherapy in Rectal Adenocarcinoma

Funding: This work has received funding from European Structural and Investment Funds through the COMPETE Programme Grant LISBOA-01-0145-FEDER-016405, from National Funds through Fundação para a Ciência e Tecnologia Programme grant SAICTPAC/0019/2015 and by a cholar from the Portuguese Society of Coloproctology as Investigation in Coloproctology Research Prize 2016–2018.Background: Patients with locally advanced rectal adenocarcinoma (LARC) are treated with neoadjuvant chemoradiotherapy (CRT). However, biomarkers for patient selection are lacking, and the association between miRNA expression and treatment response and oncological outcomes is unclear. Objectives: To investigate miRNAs as predictors of response to neoadjuvant CRT and its association with oncological outcomes. Methods: This retrospective study analyzed miRNA expression (miR-16, miR-21, miR-135b, miR-145, and miR-335) in pre- and post-chemoradiation rectal adenocarcinoma tissue and non-neoplastic mucosa in 91 patients treated with neoadjuvant CRT (50.4 Gy) and proctectomy. Two groups were defined: a pathological complete responders group (tumor regression grade—TRG 0) and a pathological incomplete responders group (TRG 1, 2, and 3). Results: miR-21 and miR-135b were upregulated in tumor tissue of incomplete responders comparing with non-neoplastic tissue (p = 0.008 and p < 0.0001, respectively). Multivariate analysis showed significant association between miR-21 in pre-CRT tumor tissue and response, with a 3.67 odds ratio (OR) of incomplete response in patients with higher miR-21 levels (p = 0.04). Although with no significance, patients treated with 5-fluorouracil (5-FU) presented reduced odds of incomplete response compared with those treated with capecitabine (OR = 0.19; 95% confidence interval (CI) 0.03–1.12, p = 0.05). Moreover, significant differences were seen in overall survival (OS) in relation to clinical TNM stage (p = 0.0004), cT (p = 0.0001), presence of distant disease (p = 0.002), mesorectal tumor deposits (p = 0.003), and tumor regression grade (p = 0.04). Conclusion: miR-21 may predict response to CRT in rectal cancer (RC).publishersversionpublishe

Potential of miR-21 to Predict Incomplete Response to Chemoradiotherapy in Rectal Adenocarcinoma

Background: Patients with locally advanced rectal adenocarcinoma (LARC) are treated with neoadjuvant chemoradiotherapy (CRT). However, biomarkers for patient selection are lacking, and the association between miRNA expression and treatment response and oncological outcomes is unclear. Objectives: To investigate miRNAs as predictors of response to neoadjuvant CRT and its association with oncological outcomes. Methods: This retrospective study analyzed miRNA expression (miR-16, miR-21, miR-135b, miR-145, and miR-335) in pre- and post-chemoradiation rectal adenocarcinoma tissue and non-neoplastic mucosa in 91 patients treated with neoadjuvant CRT (50.4 Gy) and proctectomy. Two groups were defined: a pathological complete responders group (tumor regression grade—TRG 0) and a pathological incomplete responders group (TRG 1, 2, and 3). Results: miR-21 and miR-135b were upregulated in tumor tissue of incomplete responders comparing with non-neoplastic tissue (p = 0.008 and p < 0.0001, respectively). Multivariate analysis showed significant association between miR-21 in pre-CRT tumor tissue and response, with a 3.67 odds ratio (OR) of incomplete response in patients with higher miR-21 levels (p = 0.04). Although with no significance, patients treated with 5-fluorouracil (5-FU) presented reduced odds of incomplete response compared with those treated with capecitabine (OR = 0.19; 95% confidence interval (CI) 0.03–1.12, p = 0.05). Moreover, significant differences were seen in overall survival (OS) in relation to clinical TNM stage (p = 0.0004), cT (p = 0.0001), presence of distant disease (p = 0.002), mesorectal tumor deposits (p = 0.003), and tumor regression grade (p = 0.04). Conclusion: miR-21 may predict response to CRT in rectal cancer (RC).info:eu-repo/semantics/publishedVersio